Augmentative and alternative communication (AAC) includes all forms of communication, other than oral speech, that are used to express thoughts, needs, wants, and ideas. AAC, may include, for example, facial expressions and/or gestures, sign language, the use of symbols and/or pictures, and written communication.
A variety of AAC systems exist to improve the communication skills of individuals who are nonverbal, speech and/or language impaired. AAC systems may be unaided or aided. Unaided forms of communication consist of nonverbal means of natural communication (including gestures and facial expressions) as well as manual signs and American Sign Language (ASL). Aided forms of communication systems consist of those approaches that provide a user some additional external support to convey a communication (for example, a statement, request, question, demand, or other message)
Aided communication systems may be low tech, such as a communication board or book with visual-graphic symbols or icons (i.e., pictures, photographs, line drawings, symbols, printed words, traditional orthography, and/or combinations thereof) that stand for or represent what an individual wants to express, or high tech, such as a sophisticated computer with symbols, words, letters, or icons that “speaks” for its user via either synthetically produced speech or recorded natural (digitized) speech.
A communication board or book is a no-tech or low-tech AAC system that allows expressive communication by pointing or looking at (or otherwise selecting) a symbol or icon representing the word or idea the user wishes to express. These systems may utilize direct selection (i.e. touching a picture or sentence), partner-assisted scanning with a communication partner, or eye gaze (i.e. looking to the preferred icon). Such communication systems are often static in nature (i.e., the icons remain in a fixed/immovable position on the board).
The Picture Exchange Communication System® (PECS®) protocol refers to a method of teaching language in a low-tech communication system using icons that are stored in a communication binder and are removed and exchanged by the user or communication partner to make a request or comment. The PECS protocol uses icons composed of nouns and phrase-based sentence starters such as “I want” and “I see.” Generally, the practitioner (for example, a speech language pathologist (SLP)) must create each of the icons to be used with the PECS protocol for each individual user and the icons are stored in the communication binder at the user's or practitioner's discretion. As a result, existing systems do not provide a consistent organization system for these noun words or carrier phrases and generally do not allow for the growth of expressive language beyond a comment or request.
Existing AAC systems are also generally limited in their ability to allow spontaneous novel utterance generation (SNUG). SNUG is based on access to the individual words, collocations, and commonly used phrases of our language. SNUG allows a person to say anything anytime.
SNUG depends in large part on core vocabulary. Core vocabulary refers to a set of lemmas, or base words, including nouns, pronouns, verbs, adjectives, adverbs, prepositions, conjunctions, and interjections that makes up the majority of language. About 75-85% of what we say (both as children and as adults) comes from a set of about 400-500 core vocabulary words used in most messages across all environments and situations. Typically developing children acquire language in a relatively consistent sequence of identified core vocabulary words. Conversely, only up to about 20% of what we say comes from a bank of thousands of fringe vocabulary words, mostly nouns, which are infrequently used and activity specific.
Knowing that up to about 85% of what children and adults say come from a relatively small set of core vocabulary words, it would be desirable to provide an AAC system in which core vocabulary is an integral part of the system. However, existing AAC systems generally do not include core vocabulary, but instead, consist primarily of nouns and descriptors, which tends to restrict users to requesting and labeling. Thus, existing AAC systems are generally not be flexible enough to meet most communication needs and/or allow for continued growth and language development.
Motor learning is an important key in the learning and use of an AAC system. The more cognitively impaired the person, the more he/she depends on motor learning to learn and use AAC. Motor planning comes with consistency and relative “permanence” where you get the same thing with the same movement plan. The simplest to the most complex neuro-motor activities of daily life are made possible by motor plans. Motor plans and sensory feedback are linked to language learning. Motor plans form through repetition that is meaningful, frequent, and intense. Thus, it is desirable to incorporate motor planning in AAC systems.
There are several benefits of existing low tech communication systems. In general, they are portable, relatively durable, inexpensive, not dependent on battery or electrical power, waterproof, reproducible at minimal cost, capable of teaching persistence skills, and capable of teaching functional communication skills until the user obtains a high tech communication device.
It is desirable for any user with a high tech communication device to have a low-tech system as a back-up if/when the device breaks or needs repairs. Further, any user who is non-verbal or has low functional communication skills deserves access to a low-tech system.
There are, however, some drawbacks of existing low-tech systems, including but not limited to, noun focus and activity focus (i.e., by category such as playtime, mealtime, musical instruments, animals) such that vocabulary does not transfer across environments, the fact that pre-stored phrases and sentences may not always allow student to say what they want to say, the fact that they generally do not align with typical language development, the fact that they have too many phrases and sentences, which do not teach meaning of individual words, the fact that they do not have consistent motor plan access (i.e., words and icons are repeated in different locations on different pages), the fact that they do not allow for teaching of multiple meanings of words, the fact that they lack core vocabulary, which accounts for up to 85% of what we say, and the fact that they do not allow for SNUG (i.e., do not allow for students to say what they want to say whenever they want to say it). Thus, the applicant has determined that existing approaches in these regards leave room for considerable improvement.